Project Summary Non-adherence with prescribed systemic drugs leads to poor outcomes and increases the cost of healthcare. Glaucoma, the leading cause of irreversible blindness, affects more than 70 million people worldwide. Lowering intraocular pressure, the only proven method of delaying both the development and progression of glaucoma, is typically done with topical administration of eye drops, which has notoriously low non-adherence rates: ranging from 30% to 80%. The associated cost to the healthcare system, and its impact on patients? quality of life are significant: clinic visit costs more than double as the disease progresses. The advent of smart-phone enabled technologies creates promise for improving eyedrop adherence. However, previous eyedrop electronic monitoring solutions had awkward medication bottle adjuncts and crude software for monitoring the administration of a drop which adversely affected their ability to foster significant, sustainable improvements in adherence. There is still an unmet need for wireless technology that integrates with an eyedrop bottle to sense drop administration, does not alter the shape or size of the eyedrop bottle, and can detect successful drop entry into the eye. In this project, we aim to develop a system that detects every time a drop is administered and whether the drop successfully entered the eye. This ?smart drop? technology uses newly invented flexible electronics integrated inside the label of an eyedrop bottle and a punctal plug inspired biosensor. We propose to integrate the two so that label-embedded electronics detect force and tilt information. If these patterns are indicative of an attempted drop delivery, the bottle inductively powers and probes the punctal biosensor to detect a temperature change associated with a successful drop delivery. A signal encoding the date and time will be sent from the bottle to a smartphone via Bluetooth, where it is archived or can be sent to the cloud. This enables the capability to provide reminders to the patient, provide useful information to a physician, or even a recommendation to pharmacy so that a new bottle can be made available. An easy to use, unobtrusive, wireless electronic eyedrop monitoring solution would be of significant benefit to the patients, providers, and payers associated with glaucoma.